Table 2. Mapping second order constructs to a summary of first order constructs and illustrating in which publications they appeared.

Year of research timeline	2011		2012			2013				2014								2015									2016		2017 - 2018				2nd order constructs
First order constructs	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19	20	21	22	23	24	25	26	27	28	29	30	31	32
1 Health worker attitudes surrounding HIV as a barrier or facilitator			X		X	X					X		X				X		X	X		X	X		X		X		X		X	X	Stigma
2 Concerns over lack of confidentiality			X		X			X			X		X						X	X							X			X			Confidentiatliy
3 Feeling rushed into treatment after diagnosis; patients wanting more time	X			X	X		X	X					X		X				X	X	X				X			X				X	Lack of readiness to start treatment or fear of treatment
4 Fear of not being able to take medication for life, or worried the pills will stop working				X						X							X			X		X			X						X	X
5 Worried about the side effects prevents starting ART		X		X	X									X						X		X			X		X				X	X	Inability to cope with side effects or
6 Struggled with side effects, may or may not have received counselling to manage				X	X					X	X			X			X	X		X		X			X			X			X		pill burden
7 Don’t like taking the medication (size, number, taste)											X			X			X			X	X											X
8 Feeling insufficiently informed by the provider, not getting enough information			X	X	X		X				X				X		X	X	X			X		X						X			Mixed understanding of care and treatment
9 Community outreach (targeted towards men and pregnant women) reinforced testing, adherence and HIV education				X								X		X		X		X					X	X	X
10 Fear oftransmission to baby or partner; LTFU after baby tests negative	X	X				X	X			X	X		X		X	X	X	X	X	X		X	X	X	X	X	X				X
11 Use of role models to present diagnosis as a manageable condition rather than death sentence	X		X	X			X				X					X		X		X		X		X	X
12 Received different messages by different providers; or had a different experience last pregnancy (want short-term regimine)				X	X		X			X					X									X
13 CHW (volunteers) can alleviate system burden, but may be inadequately trained		X							X			X										X	X	X	X								Rushed appointments and/or inadequate services
14 Health workers over-burdened resulting in limited counselling, poor attitudes or service delays		X		X					X			X	X					X			X	X		X		X		X
15 Clinic facilitated couple engagement or supported partner disclosure													X	X		X		X			X	X					X						Require support with disclosure
16 Fear of confiding diagnosis because of stigma, neglect, loss of social or economic support - unsupported by any clinic initiatives	X	X	X	X	X	X	X	X			X		X	X	X				X	X			X		X		X		X	X	X	X	Need for other social or financial support
17 Group counselling or ongoing counselling offered by clinic or community health services																	X				X	X		X				X		X		X
18 Mental health needs, including depression / despair, unaddressed					X												X		X	X					X						X	X
19 CHW or volunteers offer home visits or act as peer mentors																					X	X	X	X						X			Effectively followed-up through community health workers
20 Frequency of appointments needed and long waiting times makes attendance too time consuming		X			X			X	X				X						X			X					X	X					Services not available when needed
21 Cancelled services due to unreliable funding; interventions stopped, clinic hours reduced, inadequate supplies									X	X											X			X		X
22 Travel to and from health facilities takes too long or costs too much																X			X			X	X	X	X			X			X		Travel to health facility prohibitive
23 Challenges in access to quality care from trained workers because of long waiting times		X							X		X	X	X								X			X		X		X					Long waiting times
24 Multiple visits needed for HIV test, or medicines, as out of stock or without the laboratory capacity for testing		X	X									X	X		X							X		X			X	X					Need for repeat visits
25 Challenges transfering and receiving care from different clinics or with health papers / passports		X			X	X						X	X		X				X		X				X	X	X		X		X		Challenges transfering clinics when requested
26 Patient tracking: system challenges, length of time it takes to input data and upgrade system								X	X			X	X			X							X	X	X			X	X				Challenge in patient tracking
27 Crowded waiting rooms, long wait times, unwanted disclosure as a result of no privacy.													X						X			X		X		X		X		X			Lack of privacy
28 Fear of unwanted disclosure due to HIV ward/ HIV care facilities clearly marked / too obvious			X		X						X		X		X				X	X	X		X				X		X	X	X